Ileal cavernous haemangioma in an adult presenting as a rare cause of small bowel obstruction

2021 ◽  
Vol 14 (3) ◽  
pp. e239115
Author(s):  
Hitali Vasant Majethia ◽  
Vijay Waman Dhakre ◽  
Husain Gheewala ◽  
Prajesh Bhuta
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Neuroendocrine Tumour ◽  
Histopathological Analysis ◽  
Cavernous Haemangioma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Laparoscopic Assisted

Haemangiomas of the small bowel are a very rare entity and rarely considered as an aetiology for an intestinal obstruction. Contrast-enhanced CT is the investigation of choice but the lesion can be confused with malignancy or rarely a neuroendocrine tumour. Commonly it presents as abdominal pain with anaemia and/or melaena. With patients presenting without obstruction or acute gastrointestinal bleed, capsule endoscopy has shown to be a useful diagnostic tool.We present here our experience of managing a case of a patient with ileal haemangioma who presented with a subacute small bowel obstruction and underwent a laparoscopic-assisted ileal segmental resection with side-to-side anastomosis. The lesion was a cavernous haemangioma on histopathological analysis.

scholarly journals The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

2019 ◽  
pp. 4407-4410
Author(s):  
Farideh Gharekhanloo ◽  
Masoud Esnaashari
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multidetector Ct ◽  
Contrast Enhanced Ct ◽  
Technological Advances ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

Adhesion band is a major cause of small bowel obstruction. Traditionally, the obtained results of computed tomography (CT) scan were indicative of adhesion band as an etiology for small bowel obstruction. However, adhesion is easily diagnosed today due to technological advances in radiology and high-quality multidetector CT. It is important to avoid the possible complications of bowel obstruction in the early and appropriate surgical intervention. This article is a report of a 45-year-old woman with abdominal pain and history of previous abdominal surgery. A contrast-enhanced CT scan showed multiple adhesion bands ensued the abrupt narrowing of bowel diameter and closed small-bowel loops obstruction. Furthermore, multiple bands were clearly observed and adhesiolysis was performed in the surgery.

scholarly journals Case Report: Seaweed Bezoar Masquerading as a Malignant Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
E. C. Abboud ◽  
B. Babic
Keyword(s):  
Small Bowel ◽  
High Sensitivity ◽  
Bowel Loop ◽  
Asian Woman ◽  
Malignant Obstruction ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Risk Patients ◽  
High Index Of Suspicion

Bezoars represent a rare cause of small bowel obstruction (SBO). Nonoperative management of bezoars includes use of endoscopy with mechanical or chemical dissolution methods. When obstruction persists, surgical intervention becomes necessary. Here, we present the case of an Asian woman with a SBO secondary to a phytobezoar masquerading as a malignancy. She presented with two days of acute-on-chronic abdominal pain that started after eating seaweed. Initial computed tomography (CT) scan showed a SBO with a jejunal transition point and ill-defined liver lesions, worrisome for a malignant obstruction with liver metastases. Further imaging, however, showed the resolution of these artifacts. Subsequent laparotomy revealed a small bowel loop with copious obstructing seaweed. A distal stricture was palpated, and the involved segment was resected. Intraoperative liver ultrasound was negative, and final pathology revealed benign small intestine with a mild stricture. Given the rarity of bezoar-related obstructions, the diagnosis is often delayed particularly when confounding factors exist such as our patient’s concomitant hepatic findings. Contrast-enhanced CT has a high sensitivity but a lower specificity in identifying bezoars. A high index of suspicion is therefore necessary especially when managing higher risk patients.

scholarly journals Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Federica Vernuccio ◽  
Dario Picone ◽  
Gregorio Scerrino ◽  
Massimo Midiri ◽  
Giuseppe Lo Re ◽  
...  
Keyword(s):  
Small Bowel ◽  
Contrast Agent ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Intravenous Contrast ◽  
Unenhanced Ct ◽  
Enhanced Ct ◽  
Intravenous Contrast Agent

Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Results. Eighteen patients (mean age 72±15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; P=0.6547) or large bowel obstruction (71%, 5/7 patients vs. 100%, 7/7 patients; P=0.1410). Adhesions were identified on unenhanced CT as the etiology of small bowel obstruction in 80% (4/5) of patients. Tumors were identified on unenhanced CT as the etiology of large bowel obstruction in 67% (4/6) of patients. Conclusion. In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.

scholarly journals Bouveret’s syndrome treated with endoscopic electrohydraulic lithotripsy

2019 ◽  
Vol 12 (2) ◽  
pp. e228316
Author(s):  
Aysun Avci ◽  
Ismail Gögenur ◽  
Mustafa Bulut
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Neuroendocrine Tumour ◽  
Treatment Options ◽  
Bouveret’S Syndrome ◽  
Biliary Stone ◽  
Electrohydraulic Lithotripsy ◽  
Bilioenteric Fistula ◽  
Bouveret's Syndrome

Bouveret’s syndrome is a rare form of small bowel obstruction caused by a large biliary stone entering the lumen of the duodenum or the stomach through a bilioenteric fistula. Treatment options include various surgical techniques. However, recent advances in endoscopy also allow non-surgical endoscopic treatment options. We report a 68-year-old man, with a disseminated small intestinal neuroendocrine tumour, presenting with Bouveret’s syndrome without any previously reported biliary disease. He experienced a number of symptoms 1 month prior to his admittance, which were difficult to differentiate from other infectious diseases and complications due to his neuroendocrine tumour. Abdominal CT showed a biliary stone impacted in the duodenal bulb, small bowel obstruction, pneumobilia and a bilioenteric fistula. The patient was treated with endoscopic electrohydraulic lithotripsy to fragment the large gallstone in smaller retractable pieces. The patient avoided major surgery and was discharged the following day.

Diangosis of Strangulated Small Bowel Obstruction. Efficacy of Enhanced CT Scanning.

1992 ◽  
Vol 25 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Masaya Mukai ◽  
Takashi Noto ◽  
Yoshio Iwata ◽  
Masami Ikeda ◽  
Seiei Yasuda ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Ct Scanning ◽  
Enhanced Ct
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